Archives mensuelles : novembre 2014

This Japanese study triggered titles such as « e-cigarettes up to ten times more carcinogens than conventional tobacco cigarette ».

Of course, the study does NOT say this at all. This is FUD at its extreme limits. Here is the study, with the article published by Dr Farsalinos about it, and an article from Slate France denouncing the scaremongering.

Summary

Electronic cigarettes (e-cigarettes) are advertised as being safer than tobacco cigarettes products as the chemical compounds inhaled from e-cigarettes are believed to be fewer and less toxic than those from tobacco cigarettes. Therefore, continuous careful monitoring and risk management of e-cigarettes should be implemented, with the aim of protecting and promoting public health worldwide. Moreover, basic scientific data are required for the regulation of e-cigarette. To date, there have been reports of many hazardous chemical compounds generated from e-cigarettes, particularly carbonyl compounds such as formaldehyde, acetaldehyde, acrolein, and glyoxal, which are often found in e-cigarette aerosols. These carbonyl compounds are incidentally generated by the oxidation of e-liquid (liquid in e-cigarette; glycerol and glycols) when the liquid comes in contact with the heated nichrome wire. The compositions and concentrations of these compounds vary depending on the type of e-liquid and the battery voltage. In some cases, extremely high concentrations of these carbonyl compounds are generated, and may contribute to various health effects. Suppliers, risk management organizations, and users of e-cigarettes should be aware of this phenomenon.

Conclusion

Studies have shown that e-cigarettes emit toxic carbonyl compounds, generated from thermal decomposition. These substances can have adverse health effects; however, in most cases, the levels are lower than those in tobacco cigarette smoke. It is important to expand the research in this field, to better understand the source of carbonyls emitted from e-cigarettes and find ways to reduce them.

Use of e-cigarettes, and the relationship to smoking

The debate around use of e-cigarettes

E-cigarettes have been sold since 2004, and in Europe since 2006. Their popularity and availability has increased, which has led to debate around their use. Some feel that e-cigarettes could renormalise smoking, or could be a gateway to smoking by introducing non-smokers to nicotine. Others feel that they could be a useful tool in the effort to reduce tobacco consumption. To date, e-cigarettes have mainly been marketed as a cheaper and healthier alternative to smoking. However, the long-term health effects of using e-cigarettes have yet to be established. This has led to a World Health Organisation call for tighter controls on e-cigarettes.

ONS has chosen to publish preliminary findings on e-cigarette use in response to the emerging need for more information. These data were collected between January and March 2014. Complete 2014 findings are planned for publication as part of the next Adult Smoking Habits in GB publication in 2015.

Our preliminary findings

E-cigarettes were almost exclusively used by smokers and ex-smokers, Fig 11. More than 1 in 10 (12%) of cigarette smokers also used e-cigarettes, compared with 1 in 20 (5%) ex-smokers and almost none of those who had never smoked. These findings reflect those from a YouGov survey commissioned by Action on Smoking and Health (ASH). Data on e-cigarette use have also been collected as part of the Smoking Toolkit Study.

E-cigarettes were found to be used mainly as smoking cessation aids and for the perceived health benefits (compared with smoking tobacco). Over half of e-cigarette users said that their main reason for using e-cigarettes was to stop smoking, and about one in five said the main reason for their use was because they thought they were less harmful than cigarettes.

WordPress:

Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood (1,2). Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased (3), and nearly half of tobacco users use two or more tobacco products (4)

Summary

Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood (1,2). Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased (3), and nearly half of tobacco users use two or more tobacco products (4). CDC analyzed data from the 2013 National Youth Tobacco Survey* to determine the prevalence of ever (at least once) and current (at least 1 day in the past 30 days) use of one or more of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes [e-cigarettes], pipes, snus, bidis, kreteks, and dissolvable tobacco) among U.S. middle school (grades 6–8) and high school (grades 9–12) students. In 2013, 22.9% of high school students reported current use of any tobacco product, and 12.6% reported current use of two or more tobacco products; current use of combustible products (i.e., cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs) was substantially greater (20.7%) than use of other types of tobacco. Also, 46.0% of high school students reported having ever tried a tobacco product, and 31.4% reported ever trying two or more tobacco products. Among middle school students, 3.1% reported current use of cigars, and 2.9% reported current use of cigarettes, with non-Hispanic black students more than twice as likely to report current use of cigars than cigarettes. Monitoring the prevalence of the use of all available tobacco products, including new and emerging products, is critical to support effective population-based interventions to prevent and reduce tobacco use among youths as part of comprehensive tobacco prevention and control programs.

The National Youth Tobacco Survey is a cross-sectional, school-based, self-administered, pencil-and-paper questionnaire administered to U.S. middle school (grades 6–8) and high school (grades 9–12) students. Information is collected on tobacco control outcome indicators to monitor the impact of comprehensive tobacco control policies and programs (5) and regulatory authorities of the Food and Drug Administration (FDA) (6). A three-stage cluster sampling procedure was used to generate a nationally representative sample of students in grades 6–12. Of 250 schools selected for the 2013 National Youth Tobacco Survey, 187 (74.8%) participated, with a sample of 18,406 (90.7%) among 20,301 eligible students†; the overall response rate was 67.8%. Participants were asked about ever and current use of cigarettes, cigars (defined as cigars, cigarillos, or little cigars), smokeless tobacco (defined as chewing tobacco, snuff, or dip), pipes, bidis, kreteks, hookah, snus, dissolvable tobacco, and e-cigarettes. Ever use was defined as ever trying a product, and current use was defined as using a product on 1 or more days during the past 30 days. For both ever use and current use, any tobacco use was defined as reporting the use of one or more tobacco products; use of two or more tobacco products was defined as reporting the use of two or more tobacco products in the specified time, current (in the past 30 days) or ever. Combustible tobacco was defined as cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs. Noncombustible tobacco was defined as smokeless tobacco, snus, and/or dissolvable tobacco. A separate category was created for e-cigarette use. Data were adjusted for nonresponse and weighted to provide national prevalence estimates with 95% confidence intervals; statistically significant (p<0.05) differences between population subgroups were assessed using a t-test. Estimates for ever and current use are presented for each type of product, for any tobacco use, and for the use of two or more tobacco products by selected demographics for each school level (middle and high).

In 2013, 22.9% of high school students reported current use of a tobacco product, including 12.6% who reported current use of two or more tobacco products. Among all high school students, cigarettes (12.7%) and cigars (11.9%) were the most commonly reported tobacco products currently used, followed by smokeless tobacco (5.7%), hookahs (5.2%), e-cigarettes (4.5%), pipes (4.1%), snus (1.8%), kreteks (0.8%), bidis (0.6%), and dissolvable tobacco (0.4%) (Table 1). Among high school students who identified as non-Hispanic white or Hispanic, cigarettes were the product most commonly used, whereas cigar use was more common for all other race/ethnicities. Cigar use among non-Hispanic black students was nearly 50% higher than cigarette use. Younger children are less likely to try tobacco than older children with the proportions of current any tobacco users and current users of two or more tobacco products being lower among middle school students (6.5% and 2.9%, respectively) than high school students (22.9% and 12.6%, respectively). Cigars (3.1%) and cigarettes (2.9%) were the most commonly reported tobacco products currently used by middle school students, followed by pipes (1.9%); smokeless tobacco (1.4%); e-cigarettes and hookahs (1.1%); and bidis, kreteks, and snus (0.4%). The proportions of ever users of any tobacco product and ever users of two or more tobacco products were higher among high school (46.0% and 31.4%, respectively) than middle school (17.7% and 9.4%, respectively) students (Table 2).

Combustible tobacco products were the most commonly used form of tobacco among both current and ever tobacco users (Figure). Among high school students, 20.7% currently used combustible products (13.5% combustible only; 3.4% combustible and noncombustible only; 2.7% combustible and e-cigarettes only; and 1.1% combustible, noncombustible, and e-cigarettes). Of all middle school students, 5.4% currently used combustible products (4.0% combustible only; 0.8% combustible and noncombustible only; 0.4% combustible and e-cigarettes only; and 0.2% combustible, noncombustible, and e-cigarettes). Current use of only e-cigarettes was 0.6% among high school students and 0.4% among middle school students.

Discussion

In 2013, more than one in five high school students (22.9%) and more than one in 20 middle school students (6.5%) reported using a tobacco product on 1 or more days during the past 30 days. In addition, nearly half of high school students (46.0%) and almost one in five of middle school students (17.7%) had ever used tobacco. These findings indicate that continued efforts are needed to monitor and prevent the use of all forms of tobacco use among youths.

Combustible tobacco use remains the most common type of tobacco use and causes most tobacco-related disease and death in the United States (1). Nine out of 10 high school current and ever tobacco users used a combustible tobacco product (Figure). There was lower use of only noncombustible tobacco products or only e-cigarettes among both current and ever tobacco users. However, noncombustible products also pose health risks (7). Smokeless tobacco is not a safe alternative to combustible tobacco because it causes cancer and nicotine addiction (7). In addition, although the long-term impact of e-cigarette use on public health overall remains uncertain, the 2014 Surgeon General’s report found that nicotine use can have adverse effects on adolescent brain development; therefore, nicotine use by youths in any form (whether combustible, smokeless, or electronic) is unsafe (1).

Most youths who currently use tobacco believe that they will be able to stop using tobacco in the near future; unfortunately, however, many continue use well into adulthood (2). Youths who report use of multiple tobacco products are at higher risk for developing nicotine dependence; about two thirds (62.9%) of youths who use more than one tobacco product report tobacco dependence symptoms, compared with 36.0% of those who use one tobacco product (8). Thus, youths who use multiple tobacco products might be more likely to continue using tobacco into adulthood. Comprehensive youth tobacco prevention programs that prevent initiation of all types of tobacco products are critical to protect youths from tobacco use and nicotine dependence.

The findings in this report are subject to at least five limitations. First, data were only collected from youths who attended either public or private schools and might not be generalizable to all middle and high school-aged youths. Second, data were self-reported; thus, the findings are subject to recall and/or response bias. Third, current and ever tobacco use were estimated by including students who responded to using at least one of the 10 tobacco products included in the survey but might have had missing responses to any of the other nine tobacco products; missing responses were considered as nonuse, which might have resulted in conservative estimates. Fourth, nonresponse bias might have affected the results because the survey response rate was only 67.8%. Finally, estimates might differ from those derived from other nationally representative youth surveillance systems, in part because of differences in survey methods, survey type and topic, and age and setting of the target population. However, overall prevalence estimates are similar across the various youth surveys (2).

Although substantial progress has been made in decreasing cigarette use among youths (2), overall tobacco use is still high, with one in five high school students currently using tobacco and nearly half reporting they have ever used a tobacco product. Ever using a tobacco product is a concern because even one-time use of tobacco is associated with increased long-term risks for becoming a regular user (2). In April 2014, FDA issued a proposed rule to extend its jurisdiction over the manufacture, marketing, and distribution of tobacco products not currently regulated by FDA, which includes cigars, e-cigarettes, pipes, and hookahs (9). FDA is reviewing the comments received on this proposed rule. Full implementation of comprehensive tobacco control programs at CDC-recommended funding levels would be expected to result in further reductions in tobacco use and changes in social norms regarding the acceptability of tobacco use among U.S. youths (1,2,10). Additionally, considering how trends in tobacco product use and tobacco marketing changes, rigorous surveillance of all available forms of tobacco use by youths, particularly emerging products such as e-cigarettes, is essential. Rigorous surveillance of the use of all types of tobacco will inform enhanced prevention efforts that could protect the estimated 5.6 million youths in the United States currently projected to die prematurely from a smoking-related disease (1).

Summary

Methods:Mixed-mode surveys were used to obtain representative, cross-sectional samples of U.S. adults in each of 4 years.

Results:Sample sizes for 2010, 2011, 2012, and 2013 were 3,240, 3,097, 3,101, and 3,245, respectively. Ever use of electronic cigarettes increased from 1.8% (2010) to 13.0% (2013), while current use increased from 0.3% to 6.8%,p< .001. Prevalence of use increased significantly across all demographic groups. In 2013, current use among young adults 18–24 (14.2%) was higher than adults 25–44 (8.6%), 45–64 (5.5%), and 65+ (1.2%). Daily smokers (30.3%) and nondaily smokers (34.1%) were the most likely to currently use e-cigarettes, compared to former smokers (5.4%) and never-smokers (1.4%),p< .001. However, 32.5% of current electronic cigarette users are never- or former smokers.

Conclusions

There has been rapid growth in ever and current electronic cigarette use over the past 4 years. Use is highest among young adults and current cigarette smokers. Although smokers are most likely to use these products, almost a third of current users are nonsmokers, suggesting that e-cigarettes contribute to primary nicotine addiction and to renormalization of tobacco use. Regulatory action is needed at the federal, state, and local levels to ensure that these products do not contribute to preventable chronic disease.

Notes

The « nonsmokers » in the sentence « almost a third of current users are nonsmokers, suggesting that e-cigarettes contribute to primary nicotine addiction and to renormalization of tobacco use » considers ex-smokers, who stopped smoking by using vape, as non-smokers. Never smokers using vape is 1.4%. The rest thus is composed of ex-smokers.

American Council on Science and Health

A new report in the International Journal of Research and Public Health assessed e-cigarette vapor for the presence of toxins and mutagens. Researchers used various well-characterized assays, including one for genotoxicity and mutagenicity (adverse impacts on genes and mutations) known as the Ames test, invented by long-time ACSH friend, Dr. Bruce Ames.

The study authors, led by Dr. Manoj Misra (whose 4 co-authors and himself all worked for the research labs of Lorillard Tobacco Co. in Greensboro, NC), also assayed cigarette smoke and smokeless tobacco, as well as nicotine replacement therapy patches, for those same parameters (which also included quantifying inflammatory response and cytotoxicity [cell death]).

The results showed, as any objective observer of the harm reduction scenario would expect, non-detectable levels of toxins and mutagens, etc., in the e-cigarette effluent, as well as in the NRT absorbates and the smokeless tobacco products. These results held for e-cig liquids and vapors with or without flavors or nicotine, and were about 6,000-fold less-potent than the studies on combustible cigarette smoke.

ACSH’s Dr. Gil Ross had this perspective: “As more and more science on the lack of harm expected from e-cigs and their vapor come pouring in, it will — I hope — become harder and harder for those who mindlessly or corruptly oppose this lifesaving technology to participate in their destructive chorus. Prior studies, by Drs. Farsalinos on heart cells, Goniewicz and Burstyn on chemicals in e-cig vapor (i.e. their minute quantities), as well as on the general safety of vaping, as e-cig use is called, will continue to accumulate and eventually overwhelm the nay-sayers — IF the regulators and politicians will permit it.”

Included in the response on our critique of the WHO-commissioned e-cigarette review was a section discussing about the difference between lungs and the body (the latter meant to be the digestive tract) in the bio-detoxification systems. This paragraph was copied from a paper by May and Wigand “The Right to Choose: Why Governments Should Compel the Tobacco Industry To Disclose Their Ingredients”, published in the journal Essays of Philosophy. Obviously, this issue has nothing to do with philosophy. Moreover, when I checked the full text of this manuscript, I verified that there was not a single reference to any medical literature cited to support that “chemical reactions of bio-transformation and bio-detoxification do not occur” in the lungs.

By definition, the respiratory tract is one of 3 possible pathways through which environmental contaminants enter the body (the other two being the digestive tract and the skin). It would be a paradox if there were no defence mechanisms. In fact, there is a large array of defence mechanisms throughout the respiratory tract. An overview can be seen here, but there are many more. The lungs have established antioxidant mechanisms. For example glutathione transferases are important in the detoxification of lung carcinogens. Several other enzymatic systems are also present in the lungs, even for nitrosamines. The literature on this issue is very long (examples here, here, here and here). The lungs also have a cytochrome P450 enzymatic system (CYP), which is well known and very important for liver’s detoxification capacities. In some cases, the lung enzymatic systems may actually promote the toxicity of some chemicals rather than inhibiting it, but this is not different from other tissues.

It is true, and I have mentioned it repeatedly, that a GRAS substance for ingestion does not necessarily mean that it is safe for inhalation. However, it neither means that it is not safe. Fortunately in e-cigarettes there is no pyrolysis but heating at significantly lower temperatures. We definitely need more studies to detect whether some substances may be harmful when inhaled and if they can be avoided. However, this does not change the conclusion that e-cigarettes in their current state are by far less harmful that tobacco cigarettes.

New data out of Minnesota shows that despite a marked increase in e-cigarette use among Minnesota teenagers, there was a corresponding dramatic decline in tobacco cigarette smoking.

According to the report: « The 2014 Minnesota Youth Tobacco Survey found that the percent of high school students who smoked cigarettes in the past 30 days dropped from 18.1 percent in 2011 to 10.6 percent in 2014. »

At the same time: « 12.9 percent of high school students used or tried an electronic cigarette in the past 30 days. The survey found that 28 percent of high school students reported ever having tried an e-cigarette. »

The Rest of the Story

These findings add further evidence that electronic cigarettes are not currently serving as any kind of major gateway to cigarette smoking. Despite massive levels of experimentation with electronic cigarettes, youth smoking rates are falling dramatically. This pretty much rules out the hypothesis that e-cigarettes are a major gateway to smoking.

Stan Glantz has reviewed additional evidence which documents rather dramatic increases in electronic cigarette use in the past few years, some of which is occurring among nonsmokers. However, these data actually add to the evidence that e-cigarettes are not a major gateway to smoking because they demonstrate that this experimentation, even among nonsmokers, is occurring at a time when smoking rates among youth have fallen to historic low levels.

Bottom line: There is no evidence at the current time that electronic cigarettes are serving as a gateway to smoking among youth.

Unfortunately, the lack of evidence did not stop the CDC director from proclaiming publicly that e-cigarettes are a gateway to youth smoking. And sadly, I am not aware that the director has made any sort of retraction, correction, or apology.

Meanwhile, the bogus conclusion that youth electronic cigarette use is a major risk for increased youth smoking continues to deceive policy makers throughout the country and risks the formation of inappropriate and unsupported state and federal policies regarding electronic cigarettes.

Despite all the attention to the hypothetical risks of electronic cigarettes, which so far have not been shown to pose any substantial risk to young people, the policy makers remain silent about menthol cigarettes, which – according to the Minnesota report – are currentlysmoked by 44% of youth. This is not a hypothetical risk. This is not a slight chance of progression to smoking. These are kids who are already smoking and most likely already addicted to smoking. And half of these kids who continue to smoke over a lifetime will die prematurely of this addiction.

But nobody in the anti-smoking movement seems to care. It appears that we just can’t stand hypothetical or unknown risks. But known epidemics of disease and death are just fine.

Disclosure: I have not received any funding or compensation from the tobacco, electronic cigarette, or pharmaceutical industries. However, I am seeking funding from several electronic cigarette companies to conduct a behavioral study on the effects of electronic cigarettes on smoking behavior.

About the survey here :

Cigarette use among high school students drops to 10.6 percent

Minnesota’s first e-cigarette survey finds 12.9 percent used or tried e-cigs during the past month

The 2014 Minnesota Youth Tobacco Survey found that the percent of high school students who smoked cigarettes in the past 30 days dropped from 18.1 percent in 2011 to 10.6 percent in 2014.

This decline in cigarette smoking, the steepest ever recorded by the Minnesota youth survey, follows extensive efforts to curb cigarette smoking including a 2013 tobacco tax, bans on indoor smoking, and tighter restrictions on youth access to tobacco products. Minnesota also saw declines between 2011 and 2014 in the use of chewing tobacco and cigars, according to the survey.

However, for the first time, the survey also asked about e-cigarette use and found that 12.9 percent of high school students used or tried an electronic cigarette in the past 30 days. The survey found that 28 percent of high school students reported ever having tried an e-cigarette.

« These new findings indicate that our statewide efforts to reduce and prevent conventional tobacco use among Minnesota children are working, » said Minnesota Department of Health Commissioner Dr. Ed Ehlinger. « At the same time, we are seeing a wild-west approach toward e-cigarettes, which allows tobacco companies unlimited marketing access to young men and women. This has led to increasing numbers of Minnesota high school and middle school students using e-cigarettes. »

Many young people are being exposed to nicotine, which is highly addictive, through e-cigarettes. An estimated 85,900 Minnesota public school students in grades 6-12 have tried e-cigarettes, and 38,400 reported using them in the past 30 days. Nicotine is known to harm adolescent brain development. Nearly one-fourth of high school students who have tried an e-cigarette have never tried another tobacco product.

Minnesota high school students are exposed to a wide range of e-cigarette marketing tactics previously used to sell cigarettes. More than half of high school students, 57 percent, saw e-cigarette ads on TV in the past 30 days. About half, 48 percent, saw ads in convenience stores. Students also saw e-cigarettes in ads on the Internet, magazines and billboards, and in the hands of actors in movies or on TV. Retailers have also started selling candy flavored e-cigarette products.

« I have a sense of déjà vu about e-cigarettes, » Ehlinger said. « Tobacco companies are using old and well-tested marketing techniques to introduce children to a new product that delivers nicotine and potentially leads to the burden of addiction. We need to take a hard look at what actions we can take at local and state levels to stop this trend, » Ehlinger said.

E-cigarettes are having such an impact in high schools that though the percent of high school students using any of the conventional tobacco products in the past 30 days fell from 25.8 percent in 2011 to 19.3 percent in 2014, the overall rate of tobacco use including e-cigarettes stayed about the same at 24.2 percent.

E-cigarettes are often cheap to buy, can be purchased on the Internet, and are available in an array of fruit and candy flavors. E-cigarettes are not regulated by the FDA and the overall health risks are unknown. The 2014 Minnesota Youth Tobacco Survey included many questions about new products, especially electronic cigarettes, as well as traditional conventional tobacco products. Public schools and classrooms across the state were selected at random and invited to participate. Overall, 4,243 students in grades 6 through 12 took the survey.

Minnesota youth also continued to use menthol cigarettes. Menthol masks the harshness and irritation that new smokers may feel. Nearly half of high school smokers (44.3 percent) usually smoke menthols. In contrast, only 22.0 percent of Minnesota adult smokers usually smoke menthols.

Background

Electronic cigarettes (e-Cigs) are an attractive long-term alternative nicotine source to conventional cigarettes. Although they may assist smokers to remain abstinent during their quit attempt, studies using first generation e-Cigs report low success rates. Second generation devices (personal vaporisers – PVs) may result in much higher quit rates, but their efficacy and safety in smoking cessation and/or reduction in clinical trials is unreported.

Results

Sustained 50% and 80% reduction in cigs/day at week-24 was reported in 15/50 (30%) and 7/50 (14%) participants with a reduction from 25cigs/day to 6cigs/day (p < 0.001) and 3cigs/day (p < 0.001), respectively. Smoking abstinence (self-reported abstinence from cigarette smoking verified by an eCO <=10 ppm) at week-24 was observed in 18/50 (36%) participants, with 15/18 (83.3%) still using their PVs at the end of the study. Combined 50% reduction and smoking abstinence was shown in 33/50 (66%) participants. Throat/mouth irritation (35.6%), dry throat/mouth (28.9%), headache (26.7%) and dry cough (22.2%) were frequently reported early in the study, but waned substantially by week-24. Participants’ perception and acceptance of the products was very good.

Conclusion

The use of second generation PVs substantially decreased cigarette consumption without causing significant adverse effects in smokers not intending to quit..

Summary

Representative sample of US middle and high school students in 2011 (n=17,353) and 2012 (n=22,529)

Exposures

Ever and current e-cigarette use

Main outcome measures

Experimentation with, ever, and current smoking; smoking abstinence

Results

In pooled analyses, among cigarette experimenters (≥1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (≥100 cigarettes; OR= 6.31, 95% CI [5.39-7.39) and current cigarette smoking (OR=5.96 [5.67-6.27]). Current e-cigarette use was positively associated with ever smoking cigarettes (OR=7.42 [5.63-9.79]) and current cigarette smoking (OR= 7.88 [6.01-10.32]. In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR=1.53 [1.03-2.28]). Among experimenters with conventional cigarettes, ever use of e-cigarettes was also associated with lower 30-day (OR=0.24 [0.21-0.28]), 6-month (OR=0.24 [0.21-0.28]), and 1-year (OR=0.25 [0.21-0.30]) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR=0.11 [0.08-0.15]), 6-month (OR=0.11 [0.08-0.15]), and 1-year (OR=0.12 [0.07-0.18]) abstinence. Among ever smokers of cigarettes (≥100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR=0.61, [0.42-0.89]), 6-month (OR=0.53, [0.33-0.83]) and one-year (OR=0.32 [0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR=0.35 [0.18-0.69]), 6-month (OR=0.30 [0.13-0.68]), and one-year (OR=0.34 [0.13-0.87]) abstinence.

Conclusion

E-cigarette use was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes.